Health Law Paying Docs to Go Digital
The federal government, via the stimulus act, includes $30 billion in payments to doctors and hospitals. The money is to stimulate the transition to electronic medical records.
Only a minority of doctors use electronic records now. Health law backers say its worth using tax money to move more physicians into the digital age.
Colorado Public Radio Health Reporter Eric Whitney has more.
Whitney: If you think your doctor is using computers to to track your health, you're probably wrong.
Only about a third of Colorado primary care doctors are using electronic medical records in any kind of meaningful way. But there's a big coming wave of physicians who are going digital. Dr. Mark Laitos of Longmont is one of them.
Laitos: I have a whopping 2 months experience with my electronic medical record.
Whitney: Laitos is pretty typical of doctors in small family practices. They’ve been slow to start using electronic medical records, or EMRs, in part because of the cost. Now more of them are getting on board because the federal health care overhaul gives doctors up to $64,000 each if they switch to digital. Dr. Laitos says that's an important opportunity, but shouldn't be the only reason.
Laitos: It is such a large change, you need to have a compelling reason in terms of patient care, rather than just say, give me enough money and I'll do it.
Whitney: The change is foundational. When practices switch to EMRs they typically spend months re-organizing their entire workflow.
That's because electronic records are more than just digital copies of what most physicians are still scribbling on paper these days
Laitos: I now have access to such rich data, that the computer is going to remind me that my patient needs to have some type of a follow up done, that I wouldn't have been reminded of otherwise. That there are certain guidelines that expert groups have published that say, at this time the patient should get something else, that's something I didn't get a reminder of before.
The good news, is I will more frequently provide the care my pt should be getting, the bad news is, it's going to take me more time to do that.
Whitney: So doctors shouldn’t expect electronic records to save them tons of time. What they do promise is that time spent is spent effectively. That better prevention should save the health system overall money by preventing costly episodes that are hard to see coming with just paper records. Doctors want to see health care costs come down, but don’t expect electronic records to save their individual practices money.
Ehrenberger: In our experience, at best you might be able to break even.
Whitney: Dr. Dave Ehrenberger helps a network of clinics associated with Avista hospital in Louisville get on electronic records and use them effectively.
Ehrenberger: There're all sorts of horror stories about failures and thousands, and tens of thousands of dollars spent on less than satisfactory software packages, and great disruption to not only workflow, but cashflow for physicians in their offices.
Whitney: So Why bother? Ehrenberger says it's simple: electronic records are the tool of the future.
Ehrenberger: A so-called fully functional electronic health record is the new stethoscope, and without it, not only will you not be providing competent care, because you're disconnected and not tuned in, but also you're going to soon no longer be able to practice medicine, because you won't be able to be paid by organizations that are important to you, like Medicare.
Whitney: That's the stick looming after the carrot of incentive payments is gone – doctors who don't get in on electronic records in the next five years not only lose out on the payments, but Medicare will also pay them less than their digital peers.
And if making the switch is tough in Denver, it's even harder in rural Colorado, where experience is thin, and broadband is expensive, or unavailable.
Dana Moore of Centura Health helps small hospitals get wired. He says some are struggling.
Moore: I spoke to one hospital recently, they have bits and pieces, but to get everything they'd need for meaningful use will cost them at least a million dollars, just to the software vendor. And that's a lot of money for that hospital.
Whitney: Colorado is getting federal money above and beyond incentive payments to individual doctors. The stimulus package sent another $9 million here to help rural docs go digital. Nearly a thousand are now getting that help.
And that sounds like positive long-term investing to Lorez Meinhold. She’s Colorado's director of health reform implementation. She says it's time for the health care industry to catch up to modern information technology
Meinhold: we do this everyday with our ATM cards, and we can travel around the world and pull up information about what's our bank balance, and get money out in a quick and efficient way. The fact that we're not doing that with health care is a travesty.
Whitney: Dr. Dave Ehrenberger agrees that it's time for the technology to catch up. A self-described geek, he helps small family practices work with electronic records. He says they’re no picnic.
Ehrenberger: In contrast to the rest of the software industry, the software for electronic medical records is still, I would say in it's adolescent phase in terms of maturity, as an easy to use, easy to learn product.
Whitney: State officials are confident that they can get 85% of Colorado doctors using electronic medical records in five years.
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